-- MYRA F BENNETT -- CAP-128
Individual Provider (NPI-1)
Active
Counselor, Addiction (Substance Use Disorder)
Provider Information
- NPI Number
1437443504- Provider Type
- Individual Provider (NPI-1)
- Credentials
- CAP-128
- Status
- Active
Contact & Location
- Address
- 1106 JULIE LN, POWELL, WY, 824351632
- Phone
- (307) 271-7460
- Fax
- (307) 271-7460
Specialties & Taxonomies
Counselor, Addiction (Substance Use Disorder)
Primary License: WY #CAP-128